General Questions

The Columbus Municipal School District's 21st Century Community Learning Center Program would like you to respond to a few general questions and also to share your thoughts and ideas about the out-of-school-time activities and services being provided in our community. What do you think of your child’s 21st Century Program in your school district? Your answers will help make the program better for future students and families.

Question Title

* 1. Parent/Guardian Name:

Question Title

* 2. Please enter the following:

Today's Date:

Question Title

* 3. Please enter your name(s) of your students in the program.

Question Title

* 4. Please select the grade your child was in the current school year. (Please select only one.)

Question Title

* 5. How many years has your child been in the program at this school?

Question Title

* 6. Please identify any activities or services that you participated in at the community learning center.

Question Title

* 7. Please select Yes or No to respond to the following questions.

  Yes No
Did you feel that the services/activities offered were helpful and/or worthwhile for you?
Were you comfortable working with the community learning center staff?
Did the facility have adequate resources and meet your needs?
Did you get the help you were looking for?
Did you feel the services and activities offered for your children were worthwhile?
Has the center had a positive impact on any or all of your children?
Did you feel that there was good communication between the regular school staff and the out-of-school-time program?
Have you talked to your children about the program and about school in general?

Question Title

* 8. How would you rate your child’s out-of-school time program in the following areas?
Select one answer per question.

  Poor Fair Good Excellent Don’t Know
The overall program
The safety of your child while he/she is at the program
The atmosphere and comfort of the room(s) in which the program operates
The snacks that are served to your child on a daily basis
The hours of operation
The transportation provided, if any

Question Title

* 9. Was transportation provided?

Question Title

* 10. To what extent do you agree or disagree with the following statements about the program? (Select one answer per question.)

  Strongly Disagree Disagree Agree Strongly Agree Don’t Know
I am satisfied with the kinds of programs and activities offered at the program.
There is adequate quiet time for my child to complete homework.
The program has helped my child get his/her homework done on time.
There is adequate opportunity for physical activity.

Question Title

* 11. How many days per week of after-school would be ideal for your child?

Question Title

* 12. To what extent do you agree or disagree with the following statements describing your child’s experience in the 21st Century Program? (Select one answer per question.)

My child...

  Strongly Disagree Disagree Agree Strongly Agree Don’t Know
Enjoys attending the program.
Feels comfortable with the staff.
Seems happier or less stressed since participating in the program.
Has friends in the program.
Completes homework with greater ease.
Has a better attitude towards school.

Question Title

* 13. To what extent do you agree or disagree with the following statements about the afterschool staff? (Select one answer per question.)

  Strongly Disagree Disagree Agree Strongly Agree Don’t Know
I am comfortable talking with the staff.
The staff welcomes suggestions from parents.
The staff keeps me informed about my child’s day at the program.
The staff welcomes parents who wish to observe.
I am comfortable with how the staff handles discipline problems.
The staff encourages positive interactions among the children.
I am satisfied with the number of adult staff available to work with the students.
I am satisfied with the manner adult staff interact with the students.
The staff has clearly informed me about how to contact them during the afterschool program.
I am satisfied with the overall performance of the staff.

Question Title

* 14. Why does your child attend the program? (Please check all that apply.)

Question Title

* 15. What would your child be doing after school if he/she were not attending this program? (Please check all that apply.)

Your comments on the 21st Century Community Learning Centers Program:

Question Title

* 16. What do you like best about the program?

Question Title

* 17. What are some things you would like to see changed?

Question Title

* 18. How many times did you go to the afterschool program?

Question Title

* 19. Have you been involved as a volunteer in the program?

Question Title

* 20. If you would like to make additional comments, suggestions, or ask questions about the program, please use the space below.

Thank you for taking the time to complete the survey and for any comments or suggestions you may have included.

T